You are the manager of a nursing department. A new chief executive officer (CEO) has taken over the top leadership position and is requiring every nurse manager to develop at least one innovative strategy to promote quality patient care. Utilizing the nursing process as your guide, you will formulate a plan for an innovation in patient care delivery for an entire nursing department or unit. You are charged with the responsibility of developing a comprehensive and complete plan that addresses all technology services in your nursing department or unit.
For this assignment, prepare a report of 3 to 5 pages that describes the plan for innovation in patient care delivery in the nursing department or unit. It should include all of the following:
Title page
Introduction: This should explain what the paper is about, including the purpose of your report.
Assessment: Identify the area, service, or product requiring innovation. Describe how you will approach an inventory of technology for your nursing department or unit and how you will prioritize your findings.
Diagnosis: Diagnose (identify) problems, and discuss how and why innovation is needed.
Plan: Provide your suggestions and recommendations for action. You may wish to include the following:
Examine the literature surrounding and supporting your area of innovation.
Recommend the strategies and processes needed to effectively complete this innovation in the organization while protecting patient safety and quality of care.
Outline the steps that are needed to put the innovation into practice.
Evaluation: Suggests 2 to 3 questions that will measure the innovations effectiveness.
Conclusion: Summarize your report.
Citations and references: Use at least 2 to 3 current (from within the last 5 years) peer-reviewed journals, and cite them in APA format.
Unit 4 Individual Project
Student’s Name
Institutional Affiliations
Unit 4 Individual Project
Clinical innovations are implemented in healthcare organizations to address patient care issues that negatively affect patient outcomes. According to Alotaibi and Federico (2017), innovations in healthcare improve the quality of care received by patients and enhance patient safety. A rise in cases of adverse events, medication errors, and non-compliance to clinical practice guidelines can influence a hospital to implement a healthcare innovation with the aim of improving patient safety. Health information technology innovations are important tools for addressing patient care issues that contemporary health care organizations are facing (Endsley, 2010). The implementation of innovations in a healthcare organization requires proper planning. When planning to integrate a new innovation, it is important to examine the situation with the aim of identifying the problems, evaluating potential solutions, selecting the best solution, and implementing the chosen option. The nursing process is an effective planning and decision-making tool that can guide innovation planning in clinical settings (Lotfi et al., 2021). The purpose of this report is to utilize the nursing process to formulate a plan for innovation in patient care delivery for the entire nursing department or unit. The Barcode Medication Administration (BCMA) technology is an innovation that can help to promote quality patient care and enhance patient safety in a nursing department or unit.
Assessment
The nursing department has been recording rising incidences of medication errors in the past few months. Such errors have been causing preventable adverse events, some of which are life-threatening. Medication errors have been linked with a prolonged hospital stay, high mortality rates, and increasing healthcare costs in the facility. The Agency for Healthcare Research and Quality reported that approximately 7,000 deaths that are taking place in the United States are due to medication errors (Agency for Healthcare Research and Quality, 2022). As Alotaibi and Federico (2017) explain, patients who develop adverse reactions due to medication errors tend to stay longer in the hospital as the healthcare team strives to treat their medication-related complications. Additionally, the cost of caring for these patients negatively affects hospital expenditure. Another secondary problem related to prolonged length of stay is burnout. Nurses in the department have been experiencing burnout since the unit started to record increasing incidences of medication errors. The reason is that reduced rates of patient discharge increase the workload for nurses leading to emotional and physical exhaustion (Kakemam et al., 2021). The patient safety situation at the department calls for the need to implement a strategy to promote quality patient care by preventing medication errors. The goal of the innovative strategy should be to ensure accuracy in medication administration. When obtaining an inventory of technology for the nursing department, the nurse will be careful to acquire tools that specifically address medication errors. Findings will be prioritized based on the degree of impact that the existing problem has on patient outcomes.
Diagnosis
Medication errors in the nursing unit primarily occur during drug administration. Despite the availability of guidelines for nurses to follow during medication administration, some of the nurses still make mistakes that cause medication errors and adverse events for patients. According to Moudgil et al. (2021), medication errors usually occur during ordering, administration, transcription, and ordering. However, medication administration error is the most common error made by nurses in clinical settings. Within the nursing department, medication administration errors are occurring due to the lack of proper patient and drug identification before administration. In most cases, nurses administer medications to the wrong patient. They also administer the wrong dose, use the wrong route, fail to adhere to the recommended time frame or duration, and administer wrong medications to patients. In this respect, the best strategy to address the problem should aim to reduce or prevent medication errors by ensuring that nurses adhere to the 5 rights of medication administration namely; right patient, right route, right dose, right time, and the right medication.
Innovation is needed to help increase nurses’ accuracy in medication administration. It will solve the problem by helping nurses in the unit to adhere to the 5 rights of medication administration including administering medication to the right patient, using the right route, giving the right dose, administering drugs at the right time, and ensuring that it is the right medication that is being administered at any given time (Agency for Healthcare Research and Quality, 2022). Endsley (2010) recognizes the role played by innovation in addressing the challenges that today’s healthcare organizations are facing. According to Alotaibi and Federico (2017), health information technology innovations play a key role in promoting patient safety by reducing medication errors and increasing nurses’ adherence to clinical practice guidelines. It is anticipated that the nursing department will be able to address the problem of medication errors by implementing a technological innovation strategy.
Plan
The best recommendation for action is to implement the barcode medication administration (BCMA) technology in the nursing unit. The BCMA is a form of technology that improves medication administration by intercepting potential errors that might occur at the point of administration. It electronically scans bar codes on the drug and on the patient’s wristband to verify whether it is the right patient, right route, right dose, right time, and right medication. BCMA is embedded in the electronic medication administration record (eMAR) component of the Electronic Health Record (EHR) technology (Agency for Healthcare Research and Quality, 2022). Integrating BCMA with eMAR enables the EHR to capture medication administration information in real-time. Since it is tied to the eMAR of the EHR, BCMA has the capacity to detect dispensing errors that also have negative impacts on patient safety (Naidu & Alicia, 2019). The rationale for choosing the BCMA is its ability to enhance the nurse’s adherence to the 5 rights of medication administration.
Published literature supports the effectiveness of BCMA in reducing and preventing medication errors in healthcare settings. For example, a study conducted by Naidu and Alicia (2019) revealed that BCMA technology is directly linked with a reduction in medication administration errors and improvement in patient safety measures. Shah et al. (2017) conducted a study to investigate the effects of BCMA technology on patient safety. They systematically reviewed published literature to gather data. Findings from the study indicated that BCMA reduces medication errors by allowing nurses to verify the 5 rights of medication administration at the bedside before giving drugs to patients. Mulac et al. (2021) recommend the importance of ensuring work system adaptation and increased usability to optimize the use of BCMA in addressing medication errors and promoting patient safety. These strategies will be considered to effectively complete BCMA innovation in the organization while protecting patient safety and quality of care. The integration of the BCMA innovation into the nursing department will be supported by evidence contained in published literature.
The steps to put the BCMA innovation into practice will follow Kurt Lewin’s theory of organizational change. According to Lewin, change in organizations usually follows three steps namely unfreezing, change, and refreezing. The ‘unfreezing’ phase is where the existing structure is disrupted to prepare the stakeholders and employees for the planned change (Arabi et al., 2022). During this phase, the nurse leader will inform employees and the organization that a problem exists and a change is necessary. The ‘change’ phase is where the actual reform is executed. The nurse leader of the nursing department will work with information technology professionals and the nurse informaticists to integrate BCMA. During the ‘refreezing’ phase, the new changes are usually incorporated into the standard operating procedure of the organization (Arabi et al., 2022). The nurse leader will ensure that the BCMA is fully integrated into the organization’s policy to influence practice change in the verification of the 5 rights of medication administration.
Evaluation
Evaluation is a crucial aspect of change implementation. Through evaluation, an organization will be able to establish whether the BCMA technology generated the desired outcomes. The following three questions will be used to measure the effectiveness of the BCMA technology;
- Is there a reduction in rates of medication errors after BCMA technology implementation?
- How has the BCMA technology affected rates of adverse events and drug-related mortality?
- Has the nursing department recorded a reduction in healthcare costs after BCMA implementation?
Conclusion
Innovation presents significant solutions to healthcare delivery challenges that are increasingly encountered by contemporary healthcare organizations. For example, a nursing department that is recording high rates of medication errors can implement technology to help improve the quality of care and promote patient safety. The proposed innovation to address the rise in medication errors in the nursing department is the integration of BCMA technology. This innovation will solve the problem by enhancing nurses’ adherence to the 5 rights of medication administration.
References
Agency for Healthcare Research and Quality. (2022). Bar-coded medication administration. https://digital.ahrq.gov/bar-coded-medication-administration.
Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631.
Arabi, Y. M., Al Ghamdi, A. A., Al-Moamary, M., Al Mutrafy, A., AlHazme, R. H., & Al Knawy, B. A. (2022). Electronic medical record implementation in a large healthcare system from a leadership perspective. BMC Medical Informatics and Decision Making, 22(1), 66. https://doi.org/10.1186/s12911-022-01801-0
Endsley, D. S. (2010). Innovation in action: A practical guide for healthcare teams. Wiley Global Research (STMS). https://coloradotech.vitalsource.com/books/9781119096290.
Kakemam, E., Chegini, Z., Rouhi, A., Ahmadi, F., & Majidi, S. (2021). Burnout and its relationship to self-reported quality of patient care and adverse events during COVID-19: A cross-sectional online survey among nurses. Journal of Nursing Management, 29(7), 1974–1982. https://doi.org/10.1111/jonm.13359.
Lotfi, M., Zamanzadeh, V., Khodayari-Zarnaq, R., & Mobasseri, K. (2021). Nursing process from theory to practice: Evidence from the implementation of “Coming back to existence caring model” in burn wards. Nursing Open, 8(5), 2794–2800. https://doi.org/10.1002/nop2.856
Moudgil, K., Premnath, B., Shaji, J. R., Sachin, I., & Piyari, S. (2021). A prospective study on medication errors in an intensive care unit. Turkish Journal of Pharmaceutical Sciences, 18(2), 228–232. https://doi.org/10.4274/tjps.galenos.2020.95825.
Mulac, A., Mathiesen, L., Taxis, K., & Gerd Granås, A. (2021). Barcode medication administration technology use in hospital practice: a mixed-methods observational study of policy deviations. BMJ Quality & Safety, 30(12), 1021–1030. https://doi.org/10.1136/bmjqs-2021-013223.
Naidu, M. & Alicia, Y. (2019). Impact of Bar-Code Medication Administration and Electronic Medication Administration Record System in clinical practice for an effective medication administration process. Health, 11, 511-526. doi: 10.4236/health.2019.115044.
Shah, K., Lo, C., Babich, M., Tsao, N. W., & Bansback, N. J. (2017). Bar code medication administration technology: a systematic review of impact on patient safety when used with computerized prescriber order entry and automated dispensing devices. The Canadian Journal of Hospital Pharmacy, 69(5), 394–402. https://doi.org/10.4212/cjhp.v69i5.1594.